基于整体观念探讨慢性脾胃病“无证可辨”问题  

Discussion on the‘no-syndrome differentiable’problem of chronic spleen-stomach diseases from holistic concept of traditional Chinese medicine

作　　者：肖雯迪 李灿东[1,2,3] 王洋 杨丞玮[1,2,3] 于莉 XIAO Wendi;LI Candong;WANG Yang;YANG Chengwei;YU Li(Research Base of Traditional Chinese Medicine Syndrome,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;Key Laboratory on TCM Health Differentiation in Fujian Province(Fujian University of Traditional Chinese Medicine),Fuzhou 350122,China;Fujian Province 2011 TCM Health Management Collaborative Innovation Center,Fuzhou 350122,China;The Third People’s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China)

机构地区：[1]福建中医药大学中医证研究基地,福州350122 [2]福建省中医健康状态辨识重点实验室(福建中医药大学),福州350122 [3]福建省2011中医健康管理协同创新中心,福州350122 [4]福建中医药大学附属第三人民医院,福州350122

出　　处：《中华中医药杂志》2024年第10期5375-5378,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金联合基金项目(No.U1705286);全国名老中医药专家传承工作室建设项目(No.国中医药人教函[2022]75号)。

摘　　要：慢性脾胃病病程长、病情易反复,缓解期或无明显症状体征,并且随着现代检查技术的应用普及,中医临床“无证可辨”情况越发多见。其产生原因有客观与人为之分,如慢性脾胃病起病隐匿的客观因素、人为因素有症状采集不全面的“无症”等。但实际没有严格意义上的“无证”者,症是辨证的依据,慢性脾胃病“无证可辨”的解决,重点应从症状采集入手,以求“无”中寻“有”。因此,在整体观念的指导下,综合运用各种方法采集慢性脾胃病表征,包括四诊合参和三观(宏、中、微观表征参数)并用,以展开全面、规范、准确的表征参数采集。此外,辨人、辨机、辨病的辨识角度,亦能成为“无证”时的参考。Chronic spleen and stomach disease long course,the condition is easy to repeat,remission period can also have no obvious symptoms.With the popularization of modern examination technology,the situation of clinical‘non syndrome differentiable’in traditional Chinese medicine is more and more common.The causes of these problems can be divided into objective and man-made ones,such as occult onset of chronic spleen and stomach diseases,incomplete collection of symptoms,and so on.However there are no‘no-syndrome’people in the strict sense actually.Symptom is the basis of syndrome differentiation,the resolution of chronic spleen and stomach disease without syndrome differentiation should start with collecting symptoms.Therefore,we should use all kinds of methods to collect the characteristics of chronic spleen-stomach diseases under the guidance of the holistic concept,including the correlation of all the examinations and macro,medium and micro parameters.So as to conduct a comprehensive,standardized and accurate collection of characterization parameters.In addition,the view of distinguishing individual,mechanism of disease and illness can also be used as a reference for diagnosing when‘no-syndrome’.

关 键 词：无证可辨 慢性脾胃病 中医整体观 辨证依据 表征参数 

分 类 号：R256.3[医药卫生—中医内科学]